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024-741-34-1409-LUP-2004-189
/� � Application for Land Use Permit(*Shoreland*) r ,� County of Sawyer ° � PO Box 676 -Hayward WI 54843 � 715/634-8288 *Property that is located within 300'of a creek,river or stream or within 1000'of a flowage,lake or pond or has any of the above waterbodies located within � � the property's boundaries. CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. / NIdS VK/ PRINT—USE BLACK INK OR PENCIL r. � k S . ��i � n ` Owner Builder � � N `�'�/ ''�/O� /lo,�'o.�,� 5 b9-��.S o• Mailing Address Mailing Address � p f rti9. (_i`� /1. 5���'Cr- � � City,State, ip City,State,Zip �` (`nlZ- �Zz-L���� ,L Daytime Phone Daytime Phone J Additional Information: Zone District: l�� ( Lot Dimensions: � C Date lot was created: �a'� ��� Acres: I� C`��' j Is there wetland neaz the proposed structure?If yes,how far o Bui mg Land Use Floodplain:O Yes O No � (�New O Filling Chippewa Flowage:O Yes O No c9 O Addition O Dredging Driveway access off of a(Check one): � ( )Alteration ( )Grading ( )Private Rd ( )Town Rd � O Moving On O O County Hwy O State Hwy b0 � ) � ) � � Pr ary Structure Accessory Building Addition o ,.�.r, (�Dwelling ( )Gazage-attached/detached ( )Deck � O Yeaz round O#of car stalls O Porch L, (�Seasonal (}�Storage Building ( )Enclosed � (YjFrame built on site O Screenhouse O Living room c� � ( )Modular/manufactured ( )Greenhouse ( )Kitchen � � ( )Mobile/manufactured ( )Other ( )Bedroom ( )Other primary structure ( ) ( )Relocate/enlazge r \ O O O#ofnew � r� AdditionalInformation: 'r p r � � 0 T e of Construction: � (�Frame ( )Log ("�Po1e/metal ( )Block (�oncrete � ( )Other � � a�" Construction Cost:Primary Structure$ y5r C`�C'r� ,ti Accessory Building:$ /i 1 c>c;�� Addition:$ � � � � Deed:Vol `�i 1�Z, Pg `�O Certified Soil Test# r�- OZ-.��/�f � z CSM:Vol /�Pg�Lot#� Sanitary Permit# C=Z — �-// � °Q %� Plat Envelope Or: b, �{J Condo Vol Pg Year Installed: �., I� "Loads and Flows": Vol Pg Owner When Installed: cc � Previous office approvals/actions: � � Variance:# LUP:# �°� � � SP:# CUP:# � Inspection Report:# Change of Zone District: 1 ������L ����� Describe the construction using these columns. List the dimensions of each structure in a separate . column. List each story, each addition, each alteration in a separate column. ' #1. Ll��,�1 #2. #3. 'Sf Z�,"ef C�E SI--Q< < #4. Size '�'-`f ft. wide fr. wide /cJ ft. wide ft. wide 3o ft. long ft. long Z `> ft. long fr. long Floor area �Z� sq. ft. sq. ft. 25^� sq. ft. sq. fr. Hgt fmm grade /Cp to peak fr. hgt. �7 ft. hgt. ft. hgt. Stories.�_ stories / stories stories # of bedrooms� Lake/Pond/Flowa e iver/Stream ame � . 4�?� N " _ r� V' { �' �� - - �„ + _ � � Y 0 � � � � � �� � � � o, ' � � � ,��- � � _. � � �� �- �; S��KS �,�„� ;����;� � aa � ��s �y � � 3 � � — , � � � � � \ � � � c4�a $�� -- - U �,i n � �U �� y��������� _�_\ Fire Number and Name of Road � ' ^ 1 . � �r,�crL �Cc,�i 1. Enter lot dimensions and indicate north by azrow. Signature of Owner or Authorized Agent: 2. Indicate the location and size of the requested construction .J�' �_ Signature activities. •�'� • PnntName: ��� �� � � ��J 3. AlsO, 1ndlCate tlle lOcation and Qlsl.ailce to the Wel�, The above ceNfies Nat ihe li intormafion and intentions are hue and cortect.,that all w shall be performed in compliance Sept1C tazl�c ancl clialnfield, wetland azeas, lot 11nes, with me requirements of t e Sawyer Counry Zoning Ordinance and �he laws and regulations of the State of Wisconsin, and if centerline of the road and waterbodies. a��s as ow�er�5>aqem,nas me�e�n�5s�on or me owoeqs�ro perform Me work 2quested on ihis application. The above personsls hereby give permission for acxess to the property for onsM1e inspection. Permit fee: $ ���j Total land azea within 300' of the waterbody: (A) �/S,OCr,3 Total impervious surface azea [including this project] (B) ��� � (B)/(A) x 100 =% Used a � �J o-ib (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? O Yes No May 18, 2004 Issue Date Signature of I ui g gent May 18 , 2005 50% Rule: AverageRoadSetback: Expiration Date Office Comments: . � � � ii .2 . 1 � � io � � 3.13 � 1.4 � �- 9 3.12 � � .1.3 � 7 8 2.78 1 / � � , � 2.78 6 � 3 i.tr .�.2 2.99 /.�c 4 /.t3 5 �.��a � "� � �5 �.s� 4.15 -3 � �. .�I 3 _� � � 176 � q M � .4.9 .4.10 4 11 4.1 tl.l7 _ � M r> f V .4.6 G - s.�r � 1 3 �f�t 4.7 , S � � � � J J � � ' a.s .. a s,r - �.. �) 3.i2��T s.�i (�.1�� ` 5�,� S.ic �� i� ---. �/' ^ c.'vt s.sZ 4.3 � �r �� v � 4.6 4.4 �f� G'�-��''/ 3.4. 3.(, ,� .4.6 :1.5 � �� :1.4 3.2 3.3 3.5 ' ._. -� �a.4 °.14. 9.5 5 .14.3 2 9.g. - � i .ss .� l4.1 1 � .9.7 13.1 4.3 15.1 Ile.2 ! l5•fo lG.4 11�.3 16.1 12.2 15•5 15.3 o<z �6.5 a�� 15.4 15.7 .15.8 IS.2 3 i / I i�' ------� p � ^�--r.�,,,./. j'= I \\ : � '� � ;I�� �::::::: ::::: ..: `'`.a: x� , � � / �`-_ : ` � �: �'�:5.':':�:;; < <'. 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' ' '.'. ... . . . �. . . l . .� �). .;.�.:.�.. .:.. .. .. . . . . . . . . . . . . .'.'. _ ]�!.'y�. . . . . . . �. . . , . �lJ.,�{.,.,.,. . . :, , . :,, . : ,. . �. . ,, , : . . . . , ��; : : : �}r. �.`..v-ZONE X :>:..:�::>� :'� �: :.�::::. : : :.: : �:� �. . <:::>:::.: , . .,... . �} . � ;. . . . . . . :: :. . . . . . . ;::<. . . .. :: �. .::...:.:. . . .. .. ... . .. . . . . . . . . .�:..�:�.:>:«�>. : � :�.(:_. .�.:,�.: :;.:.;._>;:��,.,,:,:::,:.:.;:.:.:.::.....:.:.•,,..;..:..._.;.;...:.:.:.,:...;.:.;:... .:.;:...:.:.:.:>.,:. ..�..;.:.:.:..;�.�...:.:.:.:....:;::�.�....../:1.. �.;:��.�..... .;.:.;.:».;�>:�;>:•:�:��.:.:.�.�.�.�.�.�,.�.�...... . .. . . . . . . . . . .�. . �: '��:� I ���/��`��� � . . . '��� ''��� . . . . . ��f�,�^� '� . . . . . . . . '�I�' . . : -.i..�� .. . . . .��'• . . . . .. .. . . . .•l7..�.. . . . . . ... . . . . . .�.��.�:�'�'.'.�.�>.�.�.�.�:�?:�:�:�'�'�'�'.�.�»:�:�>:�:�:�:�:�>':':'?:�:�:�:{•}::}::::':�:�?:: .. . ...�?:•'K�.✓-% SHORELAND PRESERVATION AGREEMENT (Shoreline Veeetation Protection Area) , Land Use Permit No. �y-r�Q9 (To be entered by the Zoning Office) Index No. �-��_ WHEREAS,(list all owners) Timothy Heim owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and WHEREAS,in order to secure a Land Use Permit. NOW,THEREFORE,the owner(s)hereby certifies that,as a condition of issue of said Land Use Permit,that the SHORELINE VEGETATION PROTECTION AREA on said reai estate is intact to a minimum depth of 35'landwazd from the ordinary high-water mazk of the waterbody. The owner(s)hereby agrees to comply with the shoreland vegetative protection area requirements of Section 4.410 SHORELAND VEGETATION PROTECTION AREA, Sawyer County Zoning Ordinance,in effect on the date that the land use permit is issued by the zoning office.The owner(s)further agrees to allow authori-r.ed representatives of the Govemmental Unit to enter onto the owner's property at the following description between the hours of 8:00 A.M.and 6:00 P.M. [Section 913(1)POWERS,Sawyer County Zoning Ordinance] to inspect the structure(s)or uses authorized by said Land Use Permit and to determine if the SHORELINE VEGETATION PROTECTION AREA exists and that it is being preserved.This authorization shall terminate on the date of expiration of the land use permit. However,the owner's obligation to maintain the SHORELINE VEGETATION PROTECTION AREA in accordance with Section 4.410 SHORELAND VEGETATION PROTECTION AREA, Sawyer County Zoning Ordinance remains in effect.Violation of this Agreement will authorize, in addition to other penalties and relief required under the Sawyer County Zoning Ordinance, injunctive relief,restoration of said real estate,the revocation of said Land Use Permit and the removal of all structures approved by the issue of said Land Use Permit and the revocation of any other uses approved by the issue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer County Zoning Office. LegalDescriptionofProperty: Lot 4 of CSM vol 19, pg 246 section 34, T 41 N, R7W in the Town of Round Lake, Sawyer County, WI Th Dated this /�— day of �«� Z�,y i,".� � !l6'.: .� _ � � (Owner) (Owner) (Owner) (Owner) (Owner) (Owner) This instrument was drafted by: Sawyer County Zoning Office �